PROVIDENCE, R.I. [Brown University] — When Ju Park was studying epidemiology in graduate school, she volunteered with a harm reduction organization that trained local community members on how to prevent a drug overdose. She traveled around the state to demonstrate how the medication naloxone can be used to reverse an overdose from opioids if administered in a timely manner.
After one session, a mother whose daughter had a substance abuse disorder approached Park to share a heartbreaking story: The daughter, who had been in and out of rehabilitation centers, recently experienced a relapse. She locked herself into a bathroom alone, overdosed on drugs, and died. The mother expressed gratitude for the naloxone training and told Park that she was eager to do more to help other families dealing with addiction. Park couldn’t bear to tell the woman what she was thinking: Training bystanders how to administer naloxone wouldn’t have saved her daughter, because nobody had been present to help.
“It made me wonder: What are we doing to help people who are using drugs alone and in secret?” recalled Park, who is now an assistant professor of epidemiology (research) at Brown University’s School of Public Health and an assistant professor of medicine (research) at Brown’s Warren Alpert Medical School.
That question continued to preoccupy Park as she established the Harm Reduction Innovation Lab at Rhode Island Hospital with the mission to develop, implement and evaluate interventions to promote the health and well-being of people who use drugs.
One approach that may point toward an answer: overdose detection technologies that actively or passively monitor, detect and alert responders of a potential overdose event. Park is the lead author of a new JAMA Psychiatry commentary that explains what these technologies are and how they work. The title belies the authors’ optimism around these emerging tools: “A New Frontier in Preventing Solitary Drug Overdose Deaths.”
Park and her team aren’t just talking about overdose detection technologies — they are engaged in high-impact research to learn if these tools make sense for Rhode Islanders, and how the technologies could be used to address the opioid crisis locally as well as in the rest of the country.
Solitary drug use and the risk of dying alone
Two years ago, when Park joined the Brown faculty, the U.S. Centers for Disease Control and Prevention released data showing that almost half of people who use drugs reported using alone, and 90% of overdoses were unwitnessed by another person. A study co-authored by Park of people who use drugs in Baltimore, Providence and Boston found that nearly half of the respondents reported usually using drugs alone. These numbers were even higher than Park expected.
The under-addressed issue of solitary drug use presents a major problem: Naloxone can stop overdoses, but administration of the medication requires a bystander who is trained, equipped and willing to respond to an overdose within minutes. And as in the story shared by the mother Park met, when people relapse in secret or take drugs alone, there is no witness to help and no time to waste. The data revealed a need for in-the-moment and community-led interventions to complement existing overdose prevention efforts.